Discover the value of your entire benefits package

You may not see the result in your bank account, but your benefits can deliver a considerable boost to compensation.

By René Luthe, associate managing editor

When you evaluate your compensation, do you have an understanding of the benefits your practice provides? There’s a solid reason to do so: According to the US Bureau of Labor Statistics (BLS) in March, benefits accounted for approximately 30% of employer costs for employee compensation.

According to BLS, total benefit costs consist of five major categories: paid leave, supplemental pay, insurance, retirement and savings, and legally required benefits such as Social Security, federal and state unemployment insurance. The result, says a 2018 article in Forbes, is that “employer-paid benefits improved wages for private industry workers by 46.6%.”

How eye-care practices stack up

Respondents to the eighth annual OP salary survey reported 95.5% of employers offer medical insurance, 82.8% offer dental insurance, and 52.9% offer vision. Just over three-quarters — 76.2% — offer a qualified retirement plan. Other benefits include long-term disability (61% of respondents) and an HSA/HRA and flexible spending (60%).

Reimbursement for certification or continuing education is another common benefit in eye care: 82% of practice offer reimbursement for certification and 68.6% reimburse for recertification. Continuing education is reimbursed by 69.7%.

But the benefit most in demand, according to the practice administrators OP spoke with, is paid time-off. According to our respondents, 96.7% of practices provide it.

Other non-monetary benefits provided by ophthalmology practices, according to survey respondents, include: flexibility with work schedule (42.1% of respondents), training/assistance with professional development (55.4%), company outings (28.1%), and lunches/meals (20.7%).

Another advantage of employer-provided benefits? Most are not taxable to the employee.

Spell it out

Employers can play a prominent role in educating their employees. “Practices can do a much better job of reflecting the employees’ full benefit package and resulting effective annual wages by presenting employees with an annual total compensation package statement each year,” says Laurie K. Brown, MBA, COMT, COE, BSM Consulting. “It allows the practice to show the true value of all benefits and wages combined.” OP

A call for prior authorization reform

The Improving Seniors’ Timely Access to Care Act of 2021 would establish new requirements and transparency.

By Zack Tertel, managing editor

For patients and staff frustrated with the arduous process surrounding prior authorizations (PAs), some relief could be on the horizon.

The recently introduced Improving Seniors’ Timely Access to Care Act of 2021 (HR 3173/S 3018) would establish several requirements and standards related to PA processes under Medicare Advantage (MA) plans.

The legislation, which has been endorsed by more than 460 national and state patient, provider, and stakeholder organizations, including the American Academy of Ophthalmology (AAO), would provide “oversight and transparency while protecting beneficiaries from unnecessary care delays and denials” if enacted, according to a recent AAO press release.

Per a bill summary authored by The Congressional Research Service of the Library of Congress, the legislation would require MA plans to:

• Establish an electronic prior authorization (ePA) program and require MA plans to adopt ePA capabilities, including the ability to provide real-time decisions;
• Annually publish specified PA information, including average response time and the percentage of requests approved, to improve transparency;
• Ensure PA requests are reviewed by qualified medical personnel; and
• Protect beneficiaries from any disruptions in care due to PA requirements as they transition between MA plans.

In a recent AMA survey, 84% of physicians said the number of PAs required for prescription medications and medical services has increased over the last 5 years, and 88% reported that PA interferes with continuity of care.

In addition, a report from the U.S. Department of Health and Human Services Office of Inspector General found that MA plans denied prior authorization requests that met Medicare coverage rules and MA Organization (MAO) billing rules 13% of the time. According to the report, “avoidable delays and extra steps create friction in the program and may create an administrative burden for beneficiaries, providers, and MAOs.” OP